Korean J Transplant.  2023 Nov;37(Suppl 1):S64. 10.4285/ATW2023.F-6406.

The effect of parathyroidectomy on graft function in kidney transplant patients: a systematic review and meta-analysis

• Mahadita GW
• Widiana IGR
• Kandarini Y

• KMID: 2551651
• DOI: http://doi.org/10.4285/ATW2023.F-6406

Abstract

Background
Parathyroidectomy is performed to treat hyperparathyroidism, mainly when hypercalcemia is present. Some studies have revealed a paradoxical early reduction in allograft function following parathyroidectomy. Our study aims to determine the effect of parathyroidectomy on graft function.
Methods
We included all research articles analyzing the estimated glomerular filtration rate (eGFR) in kidney transplant re-cipients with and without parathyroidectomy. We excluded nonresearch articles, studies with insufficient data, and non-En-glish articles. The remaining articles were independently screened for relevance by their abstracts with authors. The full text of residual articles was assessed according to the inclusion and exclusion criteria. The outcome of studies is the eGFR of kidney transplant recipients. To perform a meta-analysis, Review Manager 5.4.1 (The Cochrane Collaboration) and Stata ver. 16 (StataCorp LP) were used. The effects of the parathyroidectomy on eGFR in kidney transplant recipients were analyzed by comparing the mean difference between the parathyroidectomy and nonparathyroidectomy groups. The mean difference was reported with a 95% confidence interval (CI) for dichotomous variables. The P-value was two-tailed, and statistical significance was set at <0.05.
Results
A total of three studies of 968 patients were included in this meta-analysis. Studies were conducted in Taiwan, Brazil, and Germany. All of the studies included were cohort studies. The lowest mean age of included studies is 44.7±10.7 years old. The pooled mean difference of eGFR between the parathyroidectomy and nonparathyroidectomy group in kidney transplant recipients showed higher eGFR in the nonparathyroidectomy group (–5.53 [–20.11, 9.05]; P=0.46). The result was not statistically significant.
Conclusions
In kidney transplant recipient patients, there was no statistically significant difference in eGFR between parathyroidectomy and nonparathyroidectomy.